Wellness Topics for Infants 0 to 2 Years

Formula Feeding FAQs: Getting Started

The major health organizations — including the American Academy of Pediatrics (AAP), American Medical Association (AMA), the American Dietetic Association (ADA), and the World Health Organization (WHO) — agree that breast milk is the ideal form of nutrition for babies (especially during the first 6 months). However, only you can decide what's best for you and your baby.

Whether you've decided to formula feed your baby from the start, are supplementing your breast milk with formula, or are switching from breast milk to formula, you're bound to have questions. Here are answers to some common questions about formula feeding.

What supplies do I need?

Shopping for formula-feeding supplies can be downright intimidating, especially at first. From formula to bottles, from nipples to sterilizers, the choices can seem endless for new parents.

But with most of the supplies you'll need, it's probably a good idea to hold off buying — or registering for — too much of any one type of product, whether it's formula, bottles, or nipples. After all, you may end up having to return them when you find that your baby doesn't like what you've chosen. Your little one may actually prefer something completely different.

What type of formula should I use?

Many different formulas (at a wide variety of prices) are available these days, which can make the process of choosing one a little overwhelming at first. Of course, which brand you use is up to you, your doctor, your baby, and your budget. All your friends may have told you that Brand XYZ is the way to go, but your baby might think differently.

Infant formula comes in three basic forms:

Powders that require mixing with water and are the least expensive.

Concentrates, which are liquids that require diluting with water.

Ready-to-use (or ready-to-feed) liquids that can be poured right into bottles. These are the most expensive but are convenient if you're traveling or can't get to a sterile water supply quickly.

And within those choices are even more choices. The many kinds of formula on the market include:

Cow's milk-based formulas, which make up the vast majority of formulas. Most milk-based formulas have added iron, which the AAP recommends. Use only iron-fortified formula, unless advised otherwise from you doctor.

Soy-based formulas (for babies who may be lactose intolerant or allergic to cow's milk), which sometimes have added iron. However, some babies who are allergic to cow's milk also are allergic to the protein in soy formulas. Use only iron-fortified formula, unless advised otherwise from you doctor.

Hypoallergenic formulas for babies who can't tolerate the basic formulas, like those with allergies to milk or soy proteins. The proteins in these hypoallergenic formulas are broken down to their basic components and so are easier to digest.

Some formulas can be much pricier than others. All formulas manufactured in the United States have to meet strict nutritional standards from the U.S. Food and Drug Administration (FDA), so just because a formula is name brand (versus generic) doesn't necessarily mean that it's the best for your baby.

To help you decide which one to pick when you're in that jam-packed formula aisle in the store, ask your doctor about which brands might be best for your baby. You also can talk to other parents of infants about what they use and why.

Whatever kind you choose, make sure to check the expiration date on all cans and bottles of formula, and don't use formula from leaky, dented, or otherwise damaged containers.

What about formula with DHA or ARA?

DHA (docosahexaenoic acid) and ARA (arachidonic acid) are ingredients that can be found in some, but not all, formulas.

DHA and ARA are polyunsaturated fatty acids (considered the "good" kinds of fat) that may be linked to brain and nerve development and can be found naturally in fish oils and eggs. The fatty acids are also found in breast milk. By putting DHA and ARA in infant formulas, the manufacturers are attempting to imitate breast milk.

But is it beneficial to buy an infant formula with these ingredients? The jury still seems to be out on that. Some studies have indicated that formulas supplemented with DHA and ARA benefit visual and cognitive development. But others haven't shown any significant improvement with DHA and ARA formulas.

Formula can be pricey. Any way to cut costs?

Just as you may do already for your groceries and other baby supplies, shop around for the best deals on the formula you've chosen:

Take advantage of all of the free samples and coupons you receive in the mail the first few months after your delivery. Many times, new moms are placed on mailing lists for everything baby-related, from children's book clubs to formula companies.

Clip coupons. You may even want to save some for different kinds of formula, in case you end up changing your baby's formula for some reason.

See if your child's daycare has a coupon exchange program in which parents bring in their coupons and other moms and dads take what they need.

Sign up for online coupon clubs that allow you to print and save coupons for only the things you indicate you need.

Sign up for formula companies' clubs and special programs (through the mail or online) that may offer discounts, coupons, and/or free formula and other products.

Compare prices on formula at your local grocery stores. Some stores also have special clubs that allow you to regularly save on certain products.

Check for specials at your local grocery stores and/or baby center.

See if your local wholesale/bulk items store offers your baby's formula for cheaper than local grocery stores. But don't automatically expect it to be less expensive in the long run just because it comes in a bigger container. Whether you're buying in bulk — or in bigger sizes — be sure to do the math on how much you're spending per ounce. Sometimes, it may seem like a deal when it really isn't.

What kind of bottle should I use?

Bottles come in different shapes and sizes, can be made of glass or plastic, and may be reusable or have disposable liners inside. Some babies do better with certain shapes or bottles with liners on the inside. You may need to try a few different brands before you find the one that works best for you and your baby.

It's important to note that some plastic bottles are labeled "BPA-free"— meaning that they do not contain the chemical bisphenol A, which is found in some plastics and may effect development in children. Glass bottles are free of BPA and can last for a long time, but can crack and chip, so they need to be checked frequently to avoid harm to your baby.

What kind of nipple should I use?

Walk down the nipple aisle in your local baby center and it's easy to be completely overwhelmed. For starters, nipples come in silicone (clear) or latex (brown). But the options don't end there.

The many different varieties include orthodontic nipples, rounded nipples, wide-based nipples, and flat-top nipples, just to name a few. And some are advertised as "being closer to the natural shape of a mother's breast." But which kind is best really depends on your baby and what he or she seems to prefer. After all, every baby is different.

Nipples also often come in different numbers, "stages," or "flow rates" to reflect the size of the nipple's hole, which affects the flow (i.e., slow, medium, or fast) of formula or breast milk. For example, fast flows may cause younger babies to gag or may simply give them more than they can handle, whereas slower flows may be frustrating to some babies and may cause them to suck more vigorously and gulp too much air.

But whether these different flows are necessary depends on each baby. Your little one may seem to prefer variety or may be content throughout infancy to use the same kind and size of nipple. If your baby seems fussy or frustrated with the nipple, you can certainly try a different kind (like one with a larger hole) to see if it makes any difference.

How often should nipples be replaced?

That depends on how the nipples you're using hold up to cleaning, sterilizing, and everyday use. Be sure to check them regularly for signs of wear and replace them often. Also, as your baby grows, he or she might prefer nipples that come in different sizes and flows (the holes get bigger as babies get older and are ready to handle faster flows).

What are follow-up formulas?

For babies from 4-12 months old, some manufacturers offer follow-up formulas with more nutrients. While every child's nutritional needs are different, most do not need to change to follow-up formulas. Before starting your baby on a follow-up formula — or any formula different from the one you've been using — talk to your doctor about whether this is right for your little one.

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